Animals require a supply of oxygen for cellular respiration, and they must expel carbon dioxide, the waste product of this process. As such, a major function of the circulatory system is to transport and exchange gases such as oxygen and carbon dioxide between respiratory organs and other parts of the body.
Most land animals have respiratory organs (a pair of lungs in humans) folded within their body and restricted to a location within a thoracic cavity, also known as the chest wall, where they are protected by the thoracic vertebra. Because the pair of lungs is not in direct contact with the oxygen in the environment, a structure is needed to bring oxygen to the respiratory surface of the lungs and carry carbon dioxide away from the lungs. The structure here includes the mouth and the nose (the pharynx and the nasal cavity, respectively) where air is inhaled, passes through the larynx, and down the trachea commonly referred to as the windpipe.
The trachea is a cartilaginous and membranous tube for carrying gases such as air (hence the name windpipe). It is nearly but not exactly cylindrical, as it is somewhat flattened dorsally while being rounded ventrally. Approximately at the fifth thoracic vertebra, the trachea divides into a pair of bronchi, the right bronchus and the left bronchus corresponding and leading to the right and left lungs, respectively.
The right bronchus is wider, shorter, and less abrupt in its divergence (i.e., more of a straight shot) from the trachea than the left bronchus. The right bronchus gives rise to three subsidiary bronchi: the superior (upper), middle, and inferior (lower) lobes. The left bronchus gives rise to superior and inferior lobes. Each of the lobes of the right and left bronchi divides into still yet further branches. In contrast to the right bronchus, the left bronchus is smaller in diameter but about twice as long as the right, and it has a more abrupt divergence (is more offset) from the longitudinal axis of the trachea.
During lung surgery or other health care procedures, it may be desirable at times for the health care professional to isolate one of the pair of lungs. Here, “isolate” includes but is not limited to any of the following, similar, or related techniques with any one of the pair of bronchi or lungs: intubating, occluding, deflating/collapsing, suctioning, anesthetizing, ventilating, and reinflating. For illustrative purposes only, and not by way of limitation or exclusion, a few medical procedures where health care professionals may be called on to isolate one of the lungs might occur during lung biopsy, pulmonary resection, pneumonectomy, thoracotomy, pulmonary hemorrhage, hemoptysis, bronchopleural fistula, postoperative dehiscence of a mainstem bronchial stump, non-pulmonary thoracic aortic and esophageal surgery, lobectomy, bronchial surgery, and lung transplantation.
For instance, physicians may desire to anesthetize or stop ventilation to the lung that is about to undergo operation, diagnosis, or therapy. Furthermore, physicians may desire to suction either lung in the event of any collection and secretion of bodily fluids, when, for instance, hemorrhage occurs as one example. Additionally, physicians may resuscitate the anesthetized or non-ventilated lung. While the isolated lung undergoes medical procedures, the uninvolved lung is ventilated with oxygen for the patient.
A number of devices have been developed to facilitate lung isolating techniques, including endobronchial tubes, bronchial blockers, and double-lumen tubes. However, present devices and procedures might require a scope for guiding and placing the device. Also, these devices and procedures may be time consuming, difficult to position, require a balloon to be placed carefully in the opening to a bronchus or careful positioning of a slot, resulting in malposition or migration into the trachea, require repositioning as the operator alternates procedures between lungs, and may have a large overall outer diameter. In addition, these devices may require removal of the device or withdrawal of a component of the device from one bronchus to the other bronchus so as to selectively and alternately isolate bronchi or lungs.
Through the present devices, kits, and methods, isolating techniques such as intubating, occluding, deflating/collapsing, suctioning, anesthetizing, ventilating, and reinflating, and the like can be performed. Also, the devices of the present invention can be placed without the need for a scope. In addition, the present invention is easier to position, which saves time for the patient and health care professional. The smaller outer diameter is easier to place and better tolerated by the patient than the double lumen devices. Furthermore, the device goes into one bronchus, such as the left bronchus because it is easier for placing devices than the right, or either bronchus. Blocking of either bronchus is easier with the present device. By exchanging inner cannulas (or rotating/turning an inner member), isolation of either lung selectively and alternately can be achieved without repositioning the device between the bronchi or removal of the device from the patient. Also, swapping inner cannulas (or rotating/turning the inner member) is easier than positioning a balloon to occlude a bronchus.
Therefore, it is desirable to have devices, kits, and methods of isolating lungs or bronchi as taught herein.